Occlusion of a wire-reinforced endotracheal tube in an almost completely edentulous patient.

Wire-reinforced endotracheal tubes have been advocated for use where endotracheal tube kinking is a risk. We report on a 79-year-old nearly edentulous male patient in a weakened state who managed to partially obstruct a wire-reinforced endotracheal tube, despite the presence of a soft bite block. The risk of kinking wire-reinforced endotracheal tubes is not mitigated simply because the patient is edentulous.

Residual neuromuscular blockade in the immediate postoperative period.

Neuromuscular blocking agents are among the most potent and dangerous drugs administered in the course of a general anesthetic. Their residual actions can have profound effects on a patient's ability to adequately ventilate. Understanding the basics of their actions and the methods of monitoring the level of neuromuscular blockade will assist the PACU nurse in diagnosing the cause of postoperative muscle weakness and hypoventilation.